Cardiac index measurements by transcutaneous Doppler ultrasound and transthoracic echocardiography in adult and pediatric emergency patients

Nguyen, H. Bryant; Banta, Daryl P.; Stewart, Gail; Kim, Tommy; Bansal, Ramesh; Anholm, James D.; Wittlake, William A.; Corbett, Stephen W.

doi:10.1007/s10877-010-9240-6

Cited by 32 publications

(23 citation statements)

References 37 publications

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“…However, the measurement of cardiac output is important in EDs and should be considered in future studies on shock. Novel, noninvasive, accurate techniques for its assessment may render this more practical [23][24][25].…”

Section: Discussionmentioning

confidence: 99%

Validating a pragmatic definition of shock in adult patients presenting to the ED

Li¹,

Chan²,

Sin³

et al. 2014

The American Journal of Emergency Medicine

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Section: Discussionmentioning

confidence: 99%

Validating a pragmatic definition of shock in adult patients presenting to the ED

Li¹,

Chan²,

Sin³

et al. 2014

The American Journal of Emergency Medicine

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“…Two studies have reported poor agreement of transthoracic and transesophageal echocardiographic measurement of the aortic valve (AV) and pulmonary valve (PV) diameter compared with the morphometrically determined USCOM values. These studies consequently reported poor agreement of echocardiographic, and PAC determined CO values [54, 55]. USCOM's morphometrically calibrated Doppler method is based on height and weight determined AV and PV annular diameters to calculate flow volumes, with the algorithm derived from normal 2D echocardiographic data [56].…”

Section: Discussionmentioning

confidence: 99%

Pulmonary Artery Catheter (PAC) Accuracy and Efficacy Compared with Flow Probe and Transcutaneous Doppler (USCOM): An Ovine Cardiac Output Validation

Phillips

Hood

Jacobson³

et al. 2012

Critical Care Research and Practice

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Background. The pulmonary artery catheter (PAC) is an accepted clinical method of measuring cardiac output (CO) despite no prior validation. The ultrasonic cardiac output monitor (USCOM) is a noninvasive alternative to PAC using Doppler ultrasound (CW). We compared PAC and USCOM CO measurements against a gold standard, the aortic flow probe (FP), in sheep at varying outputs. Methods. Ten conscious sheep, with implanted FPs, had measurements of CO by FP, USCOM, and PAC, at rest and during intervention with inotropes and vasopressors. Results. CO measurements by FP, PAC, and USCOM were 4.0 ± 1.2 L/min, 4.8 ± 1.5 L/min, and 4.0 ± 1.4 L/min, respectively, (n = 280, range 1.9 L/min to 11.7 L/min). Percentage bias and precision between FP and PAC, and FP and USCOM was −17 and 47%, and 1 and 36%, respectively. PAC under-measured Dobutamine-induced CO changes by 20% (relative 66%) compared with FP, while USCOM measures varied from FP by 3% (relative 10%). PAC reliably detected −30% but not +40% CO changes, as measured by receiver operating characteristic area under the curve (AUC), while USCOM reliably detected ±5% changes in CO (AUC > 0.70). Conclusions. PAC demonstrated poor accuracy and sensitivity as a measure of CO. USCOM provided equivalent measurements to FP across a sixfold range of outputs, reliably detecting ±5% changes.

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“…It has a short learning curve and has few procedural risks. There is, however, quite a proportion of unobtainable imaging, the proposed valve areas can differ significantly from the truth (specifically in elderly patients, patients who are critically ill, and patients with structural heart disease), and there can be a big difference between the estimated output and the calibrated reference value 33– 36 .…”

Section: Methods Of Hemodynamic Monitoringmentioning

confidence: 99%

Hemodynamic monitoring in the critically ill: an overview of current cardiac output monitoring methods

et al. 2016

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Critically ill patients are often hemodynamically unstable (or at risk of becoming unstable) owing to hypovolemia, cardiac dysfunction, or alterations of vasomotor function, leading to organ dysfunction, deterioration into multi-organ failure, and eventually death. With hemodynamic monitoring, we aim to guide our medical management so as to prevent or treat organ failure and improve the outcomes of our patients. Therapeutic measures may include fluid resuscitation, vasopressors, or inotropic agents. Both resuscitation and de-resuscitation phases can be guided using hemodynamic monitoring. This monitoring itself includes several different techniques, each with its own advantages and disadvantages, and may range from invasive to less- and even non-invasive techniques, calibrated or non-calibrated. This article will discuss the indications and basics of monitoring, further elaborating on the different techniques of monitoring.

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Cardiac index measurements by transcutaneous Doppler ultrasound and transthoracic echocardiography in adult and pediatric emergency patients

Abstract: The USCOM-1A hemodynamic monitoring technology showed poor correlation and agreement to standard transthoracic echocardiography measures of cardiac function. The utility of USCOM-1A in the management of critically ill patients remains to be determined.

Cited by 32 publications

References 37 publications

Validating a pragmatic definition of shock in adult patients presenting to the ED

Validating a pragmatic definition of shock in adult patients presenting to the ED

Pulmonary Artery Catheter (PAC) Accuracy and Efficacy Compared with Flow Probe and Transcutaneous Doppler (USCOM): An Ovine Cardiac Output Validation

Hemodynamic monitoring in the critically ill: an overview of current cardiac output monitoring methods

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